Vol. 2, Issue 2, Part A (2025)

Medication non-adherence among elderly patients with chronic illnesses remains a critical threat to therapeutic effectiveness, quality of life, and health-system sustainability. Age-related multimorbidity, polypharmacy, cognitive decline, and complex dosing regimens make older adults particularly vulnerable to missed or incorrect doses, leading to avoidable hospitalisations, disease progression, and increased mortality. Digital reminder applications delivered via smartphones or smartphone or tablets have emerged as promising tools to support daily self-management, though the effectiveness within elderly populations, particularly those with multimorbidity, and within nurse-led models of care remains an evolving area of study. This research aims to evaluate whether integrating a structured, nurse-led education and follow-up programme with a user-friendly reminder app can improve medication adherence in elderly patients with chronic diseases.

In this quasi-experimental or randomised controlled design (depending on the finalized protocol), elderly patients prescribed long-term pharmacotherapy will be allocated to either usual care or a nurse-led digital adherence intervention. The intervention includes an initial face-to-face session where nurses assess individual barriers, train patients (and caregivers, when available) on installing and using the reminder app, personalise alert schedules to match the medication regimen, and reinforce key self-management strategies. Follow-up telephone or in-app contacts by nurses are used to troubleshoot technical or behavioural issues and to adapt schedules when prescriptions change. Medication adherence will be assessed using a validated self-report scale and pill-count or refill measures over a defined follow-up period, supplemented by clinical indicators (e.g. blood pressure, glycaemic control) where relevant.

It is anticipated that the nurse-led digital reminder intervention will significantly improve adherence scores compared with usual care, with associated gains in disease control and reduced self-reported forgetfulness. The research also expects high acceptability and feasibility of the app when combined with personalised nurse support, even among very old adults with low baseline digital literacy. Findings from this research can inform scalable nurse-led digital adherence programmes in primary care, geriatric clinics, and community health settings.